Provider Demographics
NPI:1982943528
Name:ROCKHOLT, CRYSTAL ANN (BSN RN MSNFNP-BC)
Entity type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:ANN
Last Name:ROCKHOLT
Suffix:
Gender:F
Credentials:BSN RN MSNFNP-BC
Other - Prefix:MISS
Other - First Name:CRYSTAL
Other - Middle Name:ANN
Other - Last Name:CLINARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3001 RESERVE BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SPRING HILL
Mailing Address - State:TN
Mailing Address - Zip Code:37174-3088
Mailing Address - Country:US
Mailing Address - Phone:931-499-7244
Mailing Address - Fax:931-499-7243
Practice Address - Street 1:3001 RESERVE BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-3088
Practice Address - Country:US
Practice Address - Phone:931-499-7244
Practice Address - Fax:931-499-7243
Is Sole Proprietor?:No
Enumeration Date:2013-02-01
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN76537163W00000X
TN17353363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse